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PURPOSE: Knowledge, positive attitude and good preventive practices are keys to successful myopia control, but information on these is lacking in Africa. This study determined the KAP on myopia in Ghana. METHODS: This was a population-based cross-sectional survey conducted among adults (aged 18 years and older) living across 16 regions of Ghana between May and October 2021. Data on socio-demographic factors (sex, age, gender, level of education, working status, type of employment, monthly income, and region of residence), respondents' awareness, and knowledge, attitude and preventive practices (KAP) about myopia were collected. Composite and mean scores were calculated from eleven knowledge (total score = 61), eight attitude (48), and nine preventive practice items (33). Differences in mean scores were assessed using one-way analysis of variance (ANOVA) and standardized coefficients (ß) with 95% confidence intervals (CI), using multiple linear regression to determine the associations between the dependent (KAP) and demographic variables. RESULTS: Of the 1,919 participants, mean age was 37.4 ± 13.4 years, 42.3% were aged 18-30 years, 52.6% were men, 55.8% had completed tertiary education, and 49.2% had either heard about myopia, or accurately defined myopia as short sightedness. The mean KAP scores were 22.9 ± 23.7, 33.9 ± 5.4, and 22.3 ± 2.8, respectively and varied significantly with many of the demographic variables particularly with age group, region, marital status, and type of employment. Multiple linear regression analyses revealed significant associations between region of residence and knowledge (ß =-0.54, 95%CI:-0.87, -0.23, p < 0.001), attitude (ß =-0.24, 95%CI:-0.35,-0.14, p < 0.001) and preventive practices (ß = 0.07, 95%CI: 0.01, 0.12, p = 0.015). Preventive practices were also associated with type of employment (self-employed vs employee: ß = 0.25, 95%CI: 0.15, 4.91, p < 0.05). Knowledge scores were significantly higher in those who lived in the Greater Accra (39.5 ± 18.5) and Eastern regions (39.1 ± 17.5) and lower among those who lived in the Upper West region (6.4 ± 15.6). Government employees and those with tertiary education had significantly higher mean knowledge scores compared with non-government employees (ß = 4.56, 95%CI 1.22, 7.89, p = 0.007), and those with primary/no education (ß = 18.35, 95%CI: 14.42, 22.27, p < 0.001). CONCLUSION: Ghanaian participants had adequate knowledge of myopia but showed poor attitude and low preventive practices, which varied significantly between regions and were modified by socio-demographic factors. Further research into how education can be used to stimulate Ghanaians' engagement in preventive practices is needed.
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Conhecimentos, Atitudes e Prática em Saúde , Masculino , Adulto , Humanos , Adulto Jovem , Pessoa de Meia-Idade , Feminino , Gana , Estudos Transversais , Escolaridade , Estado CivilRESUMO
BACKGROUND: Ghana and Nigeria are the two countries in Africa that currently run the Doctor of Optometry (OD) program in sub-Saharan Africa (SSA). Optometrists in these countries are licensed to provide glaucoma care. Despite the clinically relevant practice guidelines for glaucoma, there is no data on the practice patterns for glaucoma eye care in SSA, a region with the highest prevalence of glaucoma. This study aimed to profile glaucoma diagnosis adherence to practice guidelines among optometrists in two neighbouring anglophone countries (Nigeria and Ghana). METHODS: A web-based cross-sectional survey of practising optometrists was conducted in both countries. Each country data was weighted to reflect the total number of licensed and practising optometrists at the time of this survey. Descriptive analyses were performed against demography and practice factors using survey commands to adjust for sampling weights when estimating confidence intervals (CI) around prevalence estimates. Simple and multiple logistic regression analyses were performed to identify factors associated with glaucoma diagnosis. RESULTS: A total of 493 optometrists (238, 48.3% and 255, 51.7%) from Ghana and Nigeria respectively, responded to the survey-the first to document and compare the glaucoma diagnostic criteria between optometrists in Ghana and Nigeria. More Ghanaian than Nigerian optometrists diagnosed glaucoma and over 90% in both countries reported that they frequently performed either tonometry, visual field testing, or fundus examination during glaucoma diagnosis. Ghanaian optometrists were significantly more likely to diagnose glaucoma than Nigerian optometrists (adjusted odd ratio, AOR = 6.15, 95%CI:1.63-23.15, P = .007). Optometrists who have practiced for more than 10 years (AOR = 7.04; 95%CI:1.74-28.47, P = .006) and private practice optometrists (AOR = 3.33; 95%CI:1.13-9.83, P = .03) were more likely to diagnose glaucoma. CONCLUSIONS: The study provides information for evaluating glaucoma assessment for optometrists in both countries. Optometrists in both countries are reasonably well-equipped to diagnose glaucoma and are practicing at an adequate level, but with room for improvement.
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Glaucoma , Optometristas , Optometria , Humanos , Estudos Transversais , Gana/epidemiologia , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Inquéritos e QuestionáriosRESUMO
This study aims to evaluate the acceptance and risk perception of pregnant and non pregnant women towards COVID-19 vaccines using a cross-sectional matched-sample study approach. A web-based questionnaire with closed- and open-ended questions was administered to adults older than 18 years in the sub-Saharan African (SSA) region. Respondents (n = 131) were grouped based on their pregnancy status (54 pregnant and 77 non pregnant women) and matched for comparison by age. The matched groups were compared using the chi-square test and the t-test where appropriate. Compared to non pregnant women, pregnant women reported significantly lower risk perception scores of COVID-19 infection (3.74 vs. 5.78, p < 0.001) and were less likely to take the COVID-19 vaccine (odds ratio = 0.12, 95% confidence interval (CI) 0.06-0.27, p < 0.001). A similar proportion of pregnant and non pregnant women believed in false information about the COVID-19 vaccine, and 40% of unvaccinated pregnant women (n = 40) were concerned about the safety of the vaccine. After adjustment, women's education, marital status, belief in misconceptions and risk perception were associated with non-vaccination among pregnant women. The content analysis revealed that pregnant women refused the vaccine due to mistrust of their countries' health systems, concerns about the country where the vaccines were manufactured and a lack of confidence in the production process of the vaccines. This study shows the poor acceptance of COVID-19 vaccines among pregnant women in SSA, who perceived a lower risk of COVID-19 infection. Understanding the reasons for non-acceptance and the motivation to accept the COVID-19 vaccine could guide the development of health education and promotion programmes, and aid governments and policymakers in implementing targeted policy changes.
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BACKGROUND: Vaccination remains the most powerful weapon against the emergence of new variants of coronavirus (COVID-19). However, false information about COVID-19 vaccines through various platforms including social media remains a major threat to global public health. This study examined the impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa (SSA). METHODS: A validated web-based cross-sectional study was conducted from 14 March to 16 May 2021, and was administered in both French and English to 2572 participants aged 18 years and over. Data on sociodemographic characteristics, medical and vaccination history, and the information sources (mainstream media and social media) used by the participants during the pandemic were obtained. There were three main outcomes: The vaccinated group were those who responded in the affirmation (Yes) to the question of whether they have been vaccinated against COVID-19. Those who responded 'not sure' or 'no' to the question were then asked if they were willing to be vaccinated when the vaccine became available in their home countries. The responses to this follow-up question were used to derive the second and third outcome variables of 'vaccine hesitancy' and 'vaccine resistance', respectively. A series of logistic regression analyses were used to examine the impact of information sources on the three main outcomes. RESULTS: The prevalence of COVID-19 vaccine hesitancy among the participants was lowest among newspaper readers (42%) and highest among TV (72%) and social media users (73%). The prevalence of COVID-19 vaccine-resistance was also lowest among newspaper readers (37%) but highest among social media users (87%). Multivariate analyses revealed that compared to those who did not use these information sources, SSA participants who relied on the radio (aOR 0.83, 95%CI = 0.70, 0.99), TV (aOR 0.80, 95%CI = 0.65, 0.97) and social media (aOR 0.79, 95%CI = 0.65, 0.97) for information during the pandemic were less likely to be hesitant towards taking the vaccines. However, social media users (aOR 2.13, 95%CI = 1.62, 2.80), those who watched TV (aOR 1.40, 95%CI =1.08, 1.80), relied on healthcare workers (HCWs: aOR 1.32, 95%CI = 1.07, 1.63) and families/friends (aOR 1.31, 95%CI = 1.06, 1.61) for COVID-19 related information during the pandemic were more likely to resist taking the COVID vaccines in this study. Participants who relied on the newspaper for information during the pandemic were less likely to resist the vaccines (aOR 0.77, 95%CI = 0.62, 0.95) compared to non-readers of a newspaper. CONCLUSION: We found that all six information sources except radio were strong predictors of the resistance towards COVID-19 vaccination. Further research on how these channels can be used to improve the availability of reliable healthcare information is needed. Investments in these resources will protect people and empower them to make appropriate choices about their health.
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Vacinas contra COVID-19 , COVID-19 , Humanos , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Fonte de Informação , VacinaçãoRESUMO
BACKGROUND: The COVID-19 vaccines are being rolled out across all the sub-Saharan Africa (SSA) countries, with countries setting targets for achieving full vaccination rates. The aim of this study was to compare the uptake of, resistance and hesitancy to the COVID-19 vaccine between SSA locally residents and in the diasporan dwellers. METHODS: This was a cross-sectional study conducted using a web and paper-based questionnaire to obtain relevant information on COVID-19 vaccine acceptance. The survey items included questions on demography, uptake and planned acceptance or non-acceptance of the COVID-19 vaccines among SSAs. Multinomial logistic regression was used to determine probabilities of outcomes for factors associated with COVID-19 vaccination resistance and hesitancy among SSA respondents residing within and outside Africa. RESULTS: Uptake of COVID-19 vaccines varied among the local (14.2%) and diasporan (25.3%) dwellers. There were more locals (68.1%) who were resistant to COVID-19 vaccine. Participants' sex [adjusted relative risk (ARR) = 0.73, 95% CI: 0.58 - 0.93], education [primary/less: ARR = 0.22, CI:0.12 - 0.40, and bachelor's degree: ARR = 0.58, CI: 0.43 - 0.77]), occupation [ARR = 0.32, CI: 0.25-0.40] and working status [ARR = 1.40, CI: 1.06-1.84] were associated with COVID-19 vaccine resistance among locals. Similar proportion of local and diasporan dwellers (~ 18% each) were hesitant to COVID-19 vaccine, and this was higher among health care workers [ARR = 0.25, CI: 0.10 - 0.62 and ARR = 0.24, CI:0.18-0.32, diaspora and locals respectively]. After adjusting for the potential confounders, local residents aged 29-38 years [ARR = 1.89, CI: 1.26-2.84] and lived in East Africa [ARR = 4.64, CI: 1.84-11.70] were more likely to report vaccine hesitancy. Knowledge of COVID vaccines was associated with hesitancy among local and diasporan dwellers, but perception was associated with vaccine resistance [ARR = 0.86,CI: 0.82 - 0.90] and hesitancy [ARR = 0.85, CI: 0.80 - 0.90], only among the local residents. CONCLUSIONS: Differences exist in the factors that influence COVID-19 vaccine acceptance between local SSA residents and thediasporan dwellers. Knowledge about COVID-19 vaccines affects the uptake, resistance, and hesitancy to the COVID-19 vaccine. Information campaigns focusing on the efficacy and safety of vaccines could lead to improved acceptance of COVID-19 vaccines.
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COVID-19 , Vacinas , Humanos , Vacinas contra COVID-19 , População Africana , Estudos Transversais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Probabilidade , VacinaçãoRESUMO
PURPOSE: There remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. METHODS: A self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. RESULTS: Responses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. CONCLUSIONS: African ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners' perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa.
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Lentes de Contato Hidrofílicas , Miopia , Humanos , Criança , Miopia/epidemiologia , Miopia/terapia , Atropina/uso terapêutico , Inquéritos e Questionários , África/epidemiologia , Progressão da DoençaRESUMO
Background: The coronavirus disease (COVID-19) outbreak has caused a universal health crisis resulting in significant morbidities and mortalities particularly among high-risk groups. This study sought to determine regional factors associated with knowledge and attitude towards COVID-19 mitigation practices and risk perception of contracting the disease in Sub-Saharan African (SSA) countries. Methods: A cross-sectional anonymous online study was conducted among 1970 participants between April and May 2020, during the lockdown in many SSA countries. Recruitment of participants was via WhatsApp, Facebook and emails using authors' networks. The outcome variables were KAP (knowledge, attitudes and practice) of COVID-19 and analysis of variance (ANOVA) with post hoc test was run to assess the level of KAP by four regions in SSA. Simple and multiple linear regression (MLR) analyses were performed to examine factors associated with the outcome measures in the four SSA regions. Results: Mean knowledge (P=0.707) and risk perception (P=0.904) scores by four regions in SSA did not differ significantly. However, the mean attitude score was higher among West Africans compared with Southern (P=0.019) and Central Africans (P=0.003). MLR analysis revealed that among those living in West (adjusted coefficient ß=-0.83 95% CI: -1.19, -0.48) and Southern Africa (ß=-0.91 95% CI: -1.42, -0.40), having a primary or secondary education was associated with a decrease in knowledge scores while not being worried about COVID-19 decreased risk perception scores across the four SSA regions(West [ß=-6.57, 95% CI: -7.53, -5.62], East [ß=-6.24: 95% CI: -8.34,-4.15], Central [ß=-6.51, 95% CI: -8.70, -4.31], and Southern Africa [ß=-6.06: 95% CI: -7.51, -4.60]). Except among Southern Africans, participants who practiced self-isolation had positive attitude towards COVID-19. Conclusion: Future research on health education regarding COVID-19 or a future related pandemic in SSA should target people with lower education, those who do not self-isolate, those living in Southern and Western Africa and not worried about contracting COVID-19.
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Diabetes mellitus (DM) is associated with severe COVID-19 infection and complications. This study assesses COVID-19 vaccine acceptance and hesitancy in people with DM, and explores the reasons for not being vaccinated. This was a web-based cross-sectional survey using a mixed-method approach conducted in March-May 2021, corresponding to most Sub-Saharan African (SSA) countries' early vaccine rollout period. Participants were those aged ≥18 years with self-reported DM in 11 Sub-Saharan African (SSA) countries. Responses to comments on the reasons for vaccine hesitancy and facilitators for vaccine uptake were analyzed. Of the 73 participants with DM, 65.8% were males, older than 35 years (86.3%), had postsecondary education (90%), and a significant proportion were from South Africa (39.7%), Nigeria (28.8%) and Ghana (13.7%). At the time of this study, 64.4% experienced COVID-19 symptoms, 46.6% were tested for COVID-19, of which 19.2% tested positive. Few participants (6.8%) had received a COVID-19 vaccination, 65.8% were willing to take the vaccine when it becomes available in their country, while 26.0% either refused or remained hesitant towards taking the vaccine. The main identified reasons for not taking the vaccine were: advice from religious leaders; concerns about the safety, effects, and efficacy of the vaccines; mistrust of the pharmaceutical companies producing the vaccines and the process of production; the conspiracy theories around the vaccines; and the personal belief of the participants regarding vaccination. However, participants stated they would take the vaccine if they were more educated about it, received positive feedback from those vaccinated, were rewarded for taking the vaccine, or if vaccination became a condition for travel and employment. In conclusion, this study shows that the uptake of the COVID-19 vaccine was very low in this high-risk group. Efforts to increase the uptake of COVID-19 vaccines among people with diabetes are imperative, such as the provision of education and relevant information.
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COVID-19 , Diabetes Mellitus , Vacinas , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Gana , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Motivação , Nigéria/epidemiologia , Percepção , VacinaçãoRESUMO
PURPOSE: Increased prevalence of myopia is a major public health challenge worldwide, including in Africa. While previous studies have shown an increasing prevalence in Africa, there is no collective review of evidence on the magnitude of myopia in African school children. Hence, this study reviews the evidence and provides a meta-analysis of the prevalence of myopia in African school children. METHODS: This review was conducted using the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Five computerized bibliographic databases, PUBMED, Scopus, Web of Science, ProQuest, and Africa Index Medicus were searched for published studies on the prevalence of myopia in Africa from 1 January 2000 to 18 August 2021. Studies were assessed for methodological quality. Data were gathered by gender, age and refraction technique and standardized to the definition of myopia as refractive error ≥ 0.50 diopter. A meta-analysis was conducted to estimate the prevalence. Significant heterogeneity was detected among the various studies (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed to examine the effects of outliers. RESULTS: We included data from 24 quality assessed studies, covering 36,395 African children. The overall crude prevalence of myopia over the last two decades is 4.7% (95% CI, 3.9-5.7) in African children. Although the prevalence of myopia was slightly higher in females (5.3%, 95%CI: 4.1, 6.5) than in males (3.7%, 95% CI, 2.6-4.7; p = 0.297) and higher in older [12-18 years 5.1% (95% CI, 3.8-6.3) than younger children (aged 5-11 years, 3.4%, 95% CI, 2.5-4.4; p = 0.091), the differences were not significant. There was a significantly lower prevalence of myopia with cycloplegic compared with non-cycloplegic refraction [4.2%, 95%CI: 3.3, 5.1 versus 6.4%, 95%CI: 4.4, 8.4; p = 0.046]. CONCLUSIONS: Our results showed that myopia affects about one in twenty African schoolchildren, and it is overestimated in non-cycloplegic refraction. Clinical interventions to reduce the prevalence of myopia in the region should target females, and school children who are aged 12-18 years.
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Miopia/diagnóstico , Miopia/epidemiologia , Refração Ocular , Adolescente , África/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Prevalência , Erros de Refração , Testes VisuaisRESUMO
PURPOSE: The key preventive measures adopted to minimise the spread of the coronavirus disease (COVID-19) had significant health, economic and physical impacts mostly in developing countries. This study evaluated the health, economic and physical impacts of COVID-19 lockdown measures among sub-Saharan African (SSA) population and associated demographic variations. METHODS: A total of 1970 respondents took part in this web-based cross-sectional survey during the mandatory lockdown period in most SSA. The dependent variables were health (COVID-19 infection, hospitalisation), socioeconomic (lost job, closed down business) and physical impacts (separated from family) of COVID-19. Univariate and bivariate logistic regression analyses were used to explore the factors associated with each of the dependent variables by the four sub-regions (Southern, Western, Central and East Africa). RESULTS: The respondents were aged 34.1 ± 11.5 years (range: 18-75 years) and mostly men (1099, 55%). 25.9% (n = 511) reported an impact of COVID-19 pandemic with significant regional variations (p < 0.0005, higher proportion were East 36.2% and Southern Africans 30.3%) but no gender (p = 0.334) and age group variations (p > 0.05). Among Central African respondents, more men than women lost their businesses (45.7% versus 14.3%, p = 0.002) and contracted COVID-19 infections (40.0% versus 18.2%, p = 0.024) during the study period. Multivariable analysis revealed that respondents from East (adjusted odds ratio [AOR] 1.95, 95% confidence interval [CI]: 1.42-2.69), Southern (AOR 1.46, 95% CI: 1.09-1.96) and Central Africa (AOR 1.47, 95% CI: 1.06-2.03) reported significantly higher impact of COVID-19. Those who reported family separation during the lockdown were more likely to be older participants (39-48 years, AOR 2.48, 95% CI: 1.11-5.57). CONCLUSION: One in four SSA respondents, mostly East and Southern Africans, were adversely affected by the COVID-19 pandemic during the lockdown. Interventions in high-risk populations are needed to reduce the health, socioeconomic and gender disparities in the impacts of COVID-19.
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This study investigated risk perception of contracting and dying of SARS-CoV-2 in sub-Sahara Africa during and after the lockdown periods. Two online surveys were conducted one year apart, with participants 18 years and above living in sub-Sahara Africa or the diaspora. Each survey took four weeks. The first survey was taken from 18 April to 16 May 2020, i.e., during the lockdown. The second survey was taken from 14 April to 14 May 2021, i.e., after the lockdown. A cross-sectional study using adopted and modified questionnaires for both surveys were distributed through online platforms. Question about risks perception of contracting and dying of SARS-CoV-2 were asked. The Helsinki declaration was applied, and ethical approvals were obtained. Total responses for both surveys, i.e., both during and after the lockdown, was 4605. The mean age was similar in both surveys (18-28 years). The mean risk perception scores were higher after lockdown by 3.59%. Factors associated with risk perception of COVID-19 were survey period, age group, region of residence, and occupation. Non-health care workers had a lower risk perception of COVID-19. This first comparative study on the level of risk perception of Africans during and after the lockdown shows that one in every three and every four persons in sub-Sahara Africa felt at high risk of contracting COVID-19 and thought they could die from contracting the same, respectively.
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COVID-19 , SARS-CoV-2 , Adolescente , Adulto , África Subsaariana , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Perceived risk towards the coronavirus pandemic is key to improved compliance with public health measures to reduce the infection rates. This study investigated how Sub-Saharan Africans (SSA) living in their respective countries and those in the diaspora perceive their risk of getting infected by the COVID-19 virus as well as the associated factors. METHODS: A web-based cross-sectional survey on 1969 participants aged 18 years and above (55.1% male) was conducted between April 27th and May 17th 2020, corresponding to the mandatory lockdown in most SSA countries. The dependent variable was the perception of risk for contracting COVID-19 scores. Independent variables included demographic characteristics, and COVID-19 related knowledge and attitude scores. Univariate and multiple linear regression analyses identified the factors associated with risk perception towards COVID-19. RESULTS: Among the respondents, majority were living in SSA (n = 1855, 92.8%) and 143 (7.2%) in the diaspora. There was no significant difference in the mean risk perception scores between the two groups (p = 0.117), however, those aged 18-28 years had lower risk perception scores (p = 0.003) than the older respondents, while those who were employed (p = 0.040) and had higher levels of education (p < 0.001) had significantly higher risk perception scores than other respondents. After adjusting for covariates, multivariable analyses revealed that SSA residents aged 39-48 years (adjusted coefficient, ß = 0.06, 95% CI [0.01, 1.19]) and health care sector workers (ß = 0.61, 95% CI [0.09, 1.14]) reported a higher perceived risk of COVID-19. Knowledge and attitude scores increased as perceived risk for COVID-19 increased for both SSAs in Africa (ß = 1.19, 95% CI [1.05, 1.34] for knowledge; ß = 0.63, 95% CI [0.58, 0.69] for attitude) and in Diaspora (ß = 1.97, 95% CI [1.16, 2.41] for knowledge; ß = 0.30, 95% CI [0.02, 0.58] for attitude). CONCLUSIONS: There is a need to promote preventive measures focusing on increasing people's knowledge about COVID-19 and encouraging positive attitudes towards the mitigation measures such as vaccines and education. Such interventions should target the younger population, less educated and non-healthcare workers.
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COVID-19 , Adolescente , Adulto , África Subsaariana/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Migração Humana , Humanos , Internet , Masculino , Percepção , SARS-CoV-2 , Inquéritos e Questionários , Adulto JovemRESUMO
Due to the current COVID-19 pandemic and associated high mortality in sub-Saharan Africa, there is panic among healthcare workers because of the higher risk of being infected. This study compared knowledge, attitudes, and perceptions of COVID-19 among healthcare workers (HCWs) and non-healthcare workers (non-HCWs) and examined common associated factors. A web-based cross-sectional study of 1,871 respondents (430 HCWs and 1,441 non-HCWs) was conducted while lockdown measures were in place in 4 regions of sub-Saharan Africa. Data were obtained using a validated self-administered questionnaire via an online survey platform. Mean scores were calculated and summarized using a t test for both groups. Multivariate linear regression analysis was conducted to assess the unadjusted (B) and adjusted coefficients (ß) with a confidence interval (CI) of 95%. The mean scores were slightly higher among HCWs than non-HCWs, but not statistically significant. Being worried about contracting COVID-19 was the only common factor associated with knowledge, attitudes, and perceptions between the 2 groups. Knowledge of COVID-19 was associated with attitudes and perceptions between the 2 groups. Other significant associated factors were: the sub-Saharan Africa region, ages 29 to 38 years (ß = .32; 95% CI, 0.04 to 0.60 for knowledge among non-HCWs), education (ß = -.43; 95% CI, -0.81 to -0.04; and ß = -.95; 95% CI, -1.69 to -0.22, for knowledge among non-HCWs and HCWs, respectively), practice of self-isolation (ß = .71; 95% CI, 0.41 to 1.02 for attitude among non-HCWs and HCWs (ß = .97; 95% CI, 0.45 to 1.49), and home quarantine due to COVID-19, in both groups. Policymakers and healthcare providers should consider these factors when targeting interventions during COVID-19 and other future pandemics.
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COVID-19 , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Percepção , Adulto , África Subsaariana/epidemiologia , COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Pessoal de Saúde/psicologia , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: As the search for effective treatment of coronavirus disease 2019 (COVID-19) infection continues, the public opinion around the potential use of chloroquine (CQ) in treating COVID-19 remains mixed. AIM: To examine opinion and uptake of CQ for treating COVID-19 in the sub-Saharan African (SSA) region. SETTING: This study was conducted through an online survey software titled SurveyMonkey. METHODS: Anonymous online survey of 1829 SSA countries was conducted during the lockdown period using Facebook, WhatsApp and authors' networks. Opinion and uptake of CQ for COVID-19 treatment were assessed using multivariate analyses. RESULTS: About 14% of respondents believed that CQ could treat COVID-19 and of which, 3.2% took CQ for COVID-19 treatment. Multivariate analyses revealed that respondents from Central (adjusted odds ratios [aOR]: 2.54, 95% confidence interval [CI] 1.43, 4.43) and West Africa (aOR: 1.79, 95% CI 1.15, 2.88) had higher odds of believing that CQ could treat COVID-19. Respondents from East Africa reported higher odds for uptake of CQ for COVID-19 than Central, Western and Southern Africans. Knowledge of the disease and compliance with the public health advice were associated with both belief and uptake of CQ for COVID-19 treatment. CONCLUSION: Central and West African respondents were more likely to believe in CQ as a treatment for COVID-19 whilst the uptake of the medication during the pandemic was higher amongst East Africans. Future intervention discouraging the unsupervised use of CQ should target respondents from Central, West and East African regions.
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Tratamento Farmacológico da COVID-19 , Cloroquina/uso terapêutico , Hidroxicloroquina/uso terapêutico , Pandemias/prevenção & controle , Adolescente , Adulto , África Subsaariana , Controle de Doenças Transmissíveis , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Opinião Pública , SARS-CoV-2 , Inquéritos e Questionários , Adulto JovemRESUMO
Misinformation about coronavirus disease 2019 (COVID-19) is a significant threat to global public health because it can inadvertently exacerbate public health challenges by promoting spread of the disease. This study used a convenience sampling technique to examine factors associated with misinformation about COVID-19 in sub-Saharan Africa using an online cross-sectional survey. A link to the online self-administered questionnaire was distributed to 1,969 participants through social media platforms and the authors' email networks. Four false statements-informed by results from a pilot study-were included in the survey. The participants' responses were classified as "Agree," "Neutral," and "Disagree." A multinomial logistic regression was used to examine associated factors. Among those who responded to the survey, 19.3% believed that COVID-19 was designed to reduce world population, 22.2% thought the ability to hold your breath for 10 seconds meant that you do not have COVID-19, 27.8% believed drinking hot water flushes down the virus, and 13.9% thought that COVID-19 had little effect on Blacks compared with Whites. An average of 33.7% were unsure whether the 4 false statements were true. Multivariate analysis revealed that those who thought COVID-19 was unlikely to continue in their countries reported higher odds of believing in these 4 false statements. Other significant factors associated with belief in misinformation were age (older adults), employment status (unemployed), gender (female), education (bachelor's degree), and knowledge about the main clinical symptoms of COVID-19. Strategies to reduce the spread of false information about COVID-19 and other future pandemics should target these subpopulations, especially those with limited education. This will also enhance compliance with public health measures to reduce spread of further outbreaks.
Assuntos
COVID-19 , Comunicação , Conhecimentos, Atitudes e Prática em Saúde , Adulto , África Subsaariana , Fatores Etários , Estudos Transversais , Escolaridade , Emprego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between 17 April and 17 May 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During the COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments' response and recovery strategies of any future pandemic.
Assuntos
COVID-19/psicologia , Saúde Mental , Pandemias , Adolescente , Adulto , África Subsaariana , Controle de Doenças Transmissíveis , Estudos Transversais , Emoções , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemRESUMO
Background: The unprecedented outbreak of coronavirus disease (COVID-19) drastically spread worldwide, resulting in extraordinary measures put in place in various countries including Sub Saharan Africa (SSA) countries. Objective: To assess the factors associated with compliance with the public health measures imposed by various SSA countries. Method: Cross sectional study using self-administered surveys distributed on social media platforms between April 18th and May 16th, 2020, corresponding with the mandatory lockdown period in most SSA countries. Multivariate analysis examined the associated factors. Results: The prevalence of hand hygiene, quarantine, self isolation practices, wearing of face mask and attending large gatherings during COVID-19 were 94%, 39%, 31%, 64% and 14%, respectively. In multivariate models, older age 49+ years: adjusted OR 2.13, 95%CI 1.22,3.71), females (OR 1.41,95%CI 1.03,1.93), Central African countries (OR 3.73,95%CI 2.02,6.87) were associated with wearing face mask. Living alone (aOR 1.52,95%CI 1.04,2.24) during the lockdown was associated with avoiding large gatherings including religious events. Female respondents (aOR 1.61, 95%CI 1.30, 2.00), married (aOR 1.71,95%CI 1.33,2.21) and unemployed (aOR 1.62,95%CI 1.25,2.09) SSAs were more likely to practice self-quarantine measures. Conclusion: The low prevalence of mitigation practices suggest the need for targeted education campaign programs to sensitise the population.
Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Humanos , Saúde Pública , SARS-CoV-2RESUMO
The aim of this study was to explore knowledge, practice of risk and guidelines of the novel corona virus disease (COVID-19) infection among the eye care practitioners and the potential associated factors. A cross-sectional self-administered online survey was distributed via emails and social media networks between 2nd and 18th May 2020 corresponding to the week of the lockdown in Nigeria to eye care practitioners (ECPs). Data for 823 respondents were analyzed. Knowledge and risk practice were categorized as binary outcome and univariate and multivariate linear regression were used to examine the associated factors. The mean score for COVID-19-related knowledge of public health guidelines was high and varied across the ECPs. Ophthalmic Nurses, Ophthalmologists and Optometrists showed higher COVID-19-related knowledge than other ECPs (p < 0.001), particularly those working in the private sector. More than 50% of ECPs stated they provided essential services during the COVID-19 lockdown via physical consultation, particularly the Ophthalmologists. Most respondents reported that the guidelines provided by their Association were useful but expressed their lack of confidence in attending to patients during and after the COVID-19 lockdown. Compared to other ECPs in Nigeria, more Ophthalmic Nurses received training in the use of Personal Protective Equipment (PPE). This survey is the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Nigeria. ECPs in Nigeria displayed good knowledge about COVID-19 and provided eye care services during the COVID-19 lockdown in Nigeria, despite the majority not receiving any training on the use of PPEs with concerns over attending to patients. There is need for the government to strengthen health systems by improving and extending training on standard infection prevention and control measures to ECPs for effective control of the pandemic and in the future as essential health workers.
Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , COVID-19 , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Pessoal de Saúde , Mão de Obra em Saúde , Humanos , Conhecimento , Masculino , Nigéria/epidemiologia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Contact lenses are gaining popularity in developing countries as an alternative to spectacles for the correction of refractive errors. It is needful, therefore, to generate information to guide the mode of practice, and assist the industry in developing products for the increasing contact-lenses-user population. The purpose of this study was to identify the demographic profile, as well as the knowledge, attitude to wear and care regimen of wearers of contact lenses in Ghana. METHODS: In a cross-sectional study, case folders of 87 users of contact lenses were selected from the database eye contact lenses practices. The folders were reviewed for the demographic profile, type, and purpose for which the contact lenses were prescribed. Forty-two (42) contact lenses users were then randomly surveyed, using a semi-structured questionnaire to collect information on their knowledge, lens wear regimen, and attitudes regarding lens hygiene. Chi-square test was used to test associations between demographics and lens wear variables. RESULTS: Out of the 87 cases reviewed, 46 (52.9%) were females and 41 (47.1%) males. Their ages ranged from 15 to 68 years with a mean age of 28.62 ± 9.38 years. The majority- 65 (75%) - were youthful (≤ 40 years), with the highest proportion of them - 46 (53%) - being between 20-29 years. The majority - 60 (68.9%) - had a tertiary level of education. Soft contact lenses were commonly worn by 68 (78.2%) users while 19 (21.8%) wore rigid gas permeable lenses. The purpose for wearing contact lenses included for vision correction - 46 (52.9%), followed by for cosmesis - 23 (26.4%) - and therapeutic reasons -18 (20.7%). The commonest refractive error corrected was myopia - 38 (43.7%), followed by astigmatism -19 (21.8%) and hyperopia 6 (6.9%). Among the 42 users who responded to the questionnaire, by proportion, the majority -17 users (40.5%) - were introduced to contact lenses by optometrists. All respondents reported previous symptoms associated with the use of their contact lenses, but slightly more than half, 25 (57.1%) did yearly follow-up visits. CONCLUSION: The majority of contact lenses used in Ghana are soft lenses, for the purpose of vision correction. The use of contact lenses was common among individuals in their early adulthood and those with tertiary education.
Assuntos
Lentes de Contato , Conhecimentos, Atitudes e Prática em Saúde , Erros de Refração/terapia , Perfil de Impacto da Doença , Adolescente , Adulto , Idoso , Soluções para Lentes de Contato/uso terapêutico , Estudos Transversais , Países em Desenvolvimento , Feminino , Gana , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Inquéritos e Questionários , Adulto JovemRESUMO
PURPOSE: Amplitude of accommodation varies with race and ethnicity and Hofstetter's equations are commonly used in Nigeria to calculate expected amplitude of accommodation for clinical purposes. The aim of this study was to present normative values for amplitude of accommodation for Nigerian children and to compare the measured values with those calculated using Hofstetter's equations. METHODS: A total of 688 children aged six to 16 years from three selected cities in Nigeria were included in the study. Push-up technique was employed to measure the amplitude of accommodation. The measured values were compared with the calculated values (Hofstetter's equations) using the paired t-test and Bland and Altman plots. RESULTS: The measured amplitude of accommodation for the subjects ranged from 8.00 to 25.00 D with a mean of 15.88 ± 3.46 D. The calculated minimum amplitude of accommodation ranged from 11.00 to 13.50 D with a mean of 12.09 ± 0.55 D and the calculated average amplitude of accommodation ranged from 13.17 to 16.50 D with a mean of 14.62 ± 0.73 D. The calculated maximum amplitude of accommodation ranged from 18.60 to 22.60 D with a mean of 20.34 ± 0.88 D. The t-test indicated a significant difference between the measured and calculated minimum, average and maximum amplitudes of accommodation (p < 0.0001). Also, the Bland-Altman plot suggested that there was a lack of agreement between the measured and calculated amplitudes of accommodation. CONCLUSION: The mean values of amplitude of accommodation in this study are different from those reported in the literature. Also, the measured values differed from the calculated values using Hofstetter's equation. This suggests that the use of Hosftetter's equations to predict amplitude of accommodation may not be accurate for Nigerian children.